Cerumen impaction

Also known as: Earwax impaction, Impacted earwax

What is impacted earwax?

Cerumen is the medical term for earwax. Cerumen impaction is a buildup of earwax. It can cause symptoms like hearing loss. It can also prevent a proper exam of your ear.

Cerumen is a waxy, yellowish substance that lines the inside of your ear canal. The ear canal is the tube that runs from your outer ear to your eardrum. The wax helps protect your canal from water, infection, injury, and foreign bodies.

Special glands in your ear make secretions that combine with dead skin cells to form earwax. The earwax travels with slowly growing cells of your skin. Over time, the earwax moves from the inner part of your ear canal to the entrance of the canal. Jaw movement also helps the earwax move through the canal.

Some things can cause problems with this normal process. Any type of blockage in the canal can cause a problem. Some people also may make too much earwax. This causes it to build up in the ear canal. The earwax may not totally block your ear canal. Most people have just a little buildup of earwax, which doesn’t cause any symptoms at all.

Impacted earwax is very common. With age, earwax tends to become harder and less mobile. Older adults are more likely to have problems with excess earwax.

What causes impacted earwax?

Buildup of earwax happens when your ear makes it faster than your body can remove it. This can happen with a number of health conditions, such as:

  • Bony obstruction (osteoma or exostoses)
  • Infectious disease (like external otitis, “swimmer’s ear”)
  • Dermatological disease (like eczema)
  • Autoimmune disease (like lupus)
  • Narrowed ear canal (from birth, chronic inflammation, or injury)
  • Overproduction of earwax due to injury
  • Overproduction of earwax due to retained water in the canal

Some of these conditions cause a physical obstruction. Others cause more earwax to be made. In some cases, the cause of impacted earwax is not known.

Objects placed in your ear can also lead to impacted earwax, especially if done repeatedly. This is more likely in children and young people who have no other problems with their ear canals. For example, if you use cotton swabs to remove earwax, you may push the wax deeper into your canal. Over time, this may cause complete blockage. Hearing aids, swimming plugs, and swim molds can show a similar effect with repeated use.

Who is at risk for impacted earwax?

You may be at increased risk if you have a medical condition that can cause increased earwax buildup, like eczema. You may also increase your risk if you repeatedly place objects in your ear, like a hearing aid. Older adults and people with cognitive problems also carry an increased risk.

What are the symptoms of impacted earwax?

Earwax usually does not cause any symptoms, unless it significantly builds up. Following are the most common symptoms of impacted earwax:

  • Hearing loss
  • Earache
  • Sense of ear fullness
  • Itching in the ear
  • Dizziness
  • Ringing in the ears
  • Cough

You might have only one or two of these symptoms. They often come on gradually.

The symptoms of impacted earwax may look like other medical conditions or problems. Always consult your health care provider for more information.

How is impacted earwax diagnosed?

Your health care provider can diagnose impacted earwax by taking a medical history and giving you a physical exam. This might include some simple hearing tests. Your provider should easily see the wax when looking at your ear through an otoscope.

Your provider might diagnose you with impacted earwax even if you don’t have any symptoms. For example, you might need an ear exam for another reason. If you have so much earwax that your provider can’t see into your ear canal, he or she might diagnose you with impacted earwax.

How is impacted earwax treated?

Your health care provider will determine the specific treatment for impacted earwax, based on:

  • Your age, overall health, and medical history
  • Extent of the disease
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the disease
  • Your opinion or preference

If you have symptoms of impacted earwax, your provider will probably recommend some kind of treatment. If you don’t have any symptoms, your provider will probably recommend against it, unless you need an ear exam for other reasons. Often, the earwax goes away on its own with time. On rare occasions, the removal of earwax can cause complications. Clinicians may recommend removal for people who can’t talk about their symptoms, like young children.

Treatment options include:

  • Topical agents dropped into the ear canal, to soften the earwax and gradually break it down
  • Irrigation of the ear canal with water in your clinician’s office
  • Manual removal, using special instruments in your clinician’s office

Your clinician might recommend one of these options, partly based on your other medical conditions. You might need a combination of these methods for optimal removal.

Clinicians advise against other home methods of earwax removal, like ear candling and ear vacuum kits. Studies have not shown these methods to be effective.

What are the complications of impacted earwax?

Impacted earwax itself does not usually cause complications. But certain treatments for earwax removal, on rare occasions, cause the following complications:

  • Otitis external (“swimmer’s ear”)
  • Earache
  • Transient hearing loss
  • Dizziness
  • Retention of water in the canal
  • Eardrum perforation
  • Ringing in the ears
  • Bleeding from the ear

Different removal techniques carry different risks for these complications. Your own risk for depends on your other medical conditions. For example, people with diabetes may have a greater risk for otitis external. Talk with your health care provider about the risks that most apply to you.

Can impacted earwax be prevented?

You may not be able to prevent impacted earwax if you have a predisposing medical condition, like eczema. If you don’t, you might be able to prevent repeated episodes. Using a topical agent once a week may help. You may also need to plan for a routine cleaning of the ear every 6 months or so. Doctors recommend against using cotton swabs. This often pushes the earwax farther back down your ear canal.

When should I call my health care provider?

Call your health care provider if you have severe symptoms after your earwax removal, like bleeding from your ears or significant ear pain.

Key points

Cerumen, or earwax, is a normal substance that helps protect the inside of your ear canal. When it builds up excessively, it sometimes causes symptoms. Earwax buildup is more common in older adults.

  • Certain medical conditions increase the likelihood of impacted earwax.
  • Impacted earwax can cause symptoms like temporary hearing loss.
  • You might need special drops to help remove your earwax, or you might need an office procedure to remove it.
  • Never try to remove your own earwax manually.
  • Ask your health care provider if you can do anything to prevent impacted earwax in the future.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.